Bessel van der Kolk’s trauma book The Body Keeps the Score has been incredibly popular since its release in 2014 – and it shows no sign of slowing down. The author’s perspective on healing traumatic stress has been a hit with trainee health professionals, experts and the general population, with more than 2 million copies sold globally.
Despite being released eight years ago (as of April 2022) The Body Keeps the Score is #1 on the New York Times bestseller list for non-fiction paperbacks, a list it has topped since February 14, 2021. Perhaps the book has been boosted by the shared experiences of lockdowns and losses during the coronavirus pandemic, as understanding and normalisation of mental health struggles continue to gather momentum.
Non-fiction bestsellers are often tied to significant social and political moments – The Great Influenza hit top spot as the pandemic took hold in early 2020, followed by So You Want To Talk About Race after George Floyd was murdered and Black Lives Matter dominated headlines.
Experiences during the Covid pandemic may help a wide audience to appreciate one of the book’s key messages – that it helps look at the whole person in the context of their lives, rather than rely solely on diagnosis and medication for a set of symptoms.
During the pandemic the impact of self-care, and the subtlety with which trauma and stress can impact our bodies, has been impossible to ignore. The book’s success also reflects a growing understanding and acceptance of trauma following movements such as #MeToo and Black Lives Matter.
The Body Keeps The Score’s popularity comes at a time when people are paying closer attention than ever to their own history and how trauma impacts them in the present.
See also: Trauma Re-enactment and the Cycle of Suffering (Brighton therapy Partnership 2022).
Van der Kolk pulls no punches in his book, and demands better care for trauma victims. His fury towards the scientific and caring professions is evident – for failing to take trauma seriously for far too long.
He asks: How many child abuse sufferers have gone under the radar, when compared to war veterans who have a treatment path through PTSD?
How, for so long, did experts claim that incest barely existed in the US, when we now know how wildly inaccurate that is?
Van der Kolk also takes issue with a tendency to slap multiple labels or diagnoses on individuals who have been traumatised, relying on medication rather than addressing the causes.
‘Then’ from ‘now’
The Body Keeps The Score seeks to take away the blame and shame of trauma, normalising trauma responses in the process. As suggested by its title, it encourages the reader to recognise the powerful connections between mind and body.
The author notes how trauma sufferers simultaneously remember too much and too little – suppressing conscious memories which could be overwhelming as a defence mechanism, while the body remembers or ‘keeps the score’, which can lead to disproportionate responses.
Trauma therefore leaves scars on our bodies which were initially designed to protect us, but have gone too far and leave our pain prolonged and accentuated.
Treatment needs to rebalance the relationship between the rational and emotional brain – to integrate our experiences and separate ‘then’ from ‘now’.
See Also: Working With Dissociation (Brighton Therapy Partnership 2021).
The book combines the author’s personal experiences and observations with a body of research to support his holistic healing approach.
Van der Kolk provides evidence for the benefits of treatment methods which have been dismissed as ‘hippy’ approaches in the past, such as mindfulness and yoga. He also argues that sociability is an important goal and cure of trauma.
With yoga in particular, van der Kolk explains how trauma sufferers are often dissociated from their bodies, and yoga can help to rediscover a connection.
He explains how the rational mind can’t do the repair work on its own, as the logical brain is working hard to pretend we are OK. That’s why we need other therapies, such as mindfulness, yoga or EMDR, to find a new perspective and help integrate our experiences.
The book advocates a wide range of treatment planning options. It explores Cognitive Behavioural Therapy (CBT), Eye Movement Desensitization and Reprocessing therapy (EMDR), Neurofeedback, the Internal Family System approach (IFS) and many more.
Van der Kolk offers insights into his style – he argues the two most important phrases for a trauma therapist are ‘notice that’ and ‘what happens next?’.
He also urges therapists to enable clients to recruit their own strength and self-love, and to access their own internal managers and regulators, and for practitioners to avoid trying to ‘fill the holes’.
For treatment planning, the book offers four key points to focus on:
1) Find a strategy to become calm.
2) Learn to remain calm when triggered into historical thoughts and emotions.
3) Discover a way to become alive in the present and engaged with others.
4) Avoid keeping secrets from yourself about the past and how you have learned to survive.
See also: EMDR: The Breakthrough Therapy (Brighton Therapy Partnership, 2022).
The graphic descriptions of abuse in The Body Keeps The Score, coupled with its wide reach, mean the book perhaps should come with a trigger warning.
Many readers may have turned to the book to seek personal relief from their own trauma, and online reviews suggest this trigger risk has become a challenging reality for some.
However, for those training and working as therapists, being able to tolerate the reality of trauma for our clients is essential to support healing.
The frank and honest tone of the book also allows for the author’s intimacy and authenticity to shine through. Van der Kolk conveys clear affection for his clients, and places great prominence on their individual descriptions of how trauma impacts them differently.
The Body Keeps the Score calls for a re-evaluation of what trauma is, and the removal of misconceptions.
Trauma is more common than many people realise and it falls on a spectrum. Specific events – such as incidents of abuse – can be seen as ‘Big T Trauma’.
‘Small t traumas’ are just as important, even though they can often be more subtle, sometimes be disregarded as insignificant, or be a build-up of experience over time.
The Body Keeps The Score also resonates amid the drip, drip of horror we are exposed to in modern life.
The news is full of trauma on a daily basis, particularly due to war, disease and poverty.
We now all have shared, conscious and permissible struggles. We all have witnessed firsthand what our environment can do to our minds and bodies.
As a consequence, trauma has become more mainstream and accepted. Perhaps we are on a course to start empathising with each other more readily, rather than default to vilifying.
Perhaps The Body Keep’s The Score’s popularity also reflects a growing confidence in the power of therapy to benefit everyone.
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Our Guest Blogger:
Oli Hamilton is a Psychotherapeutic Counsellor specialising in the field of Transactional Analysis psychotherapy. He works in private practice from the Palmeira Practice in Hove. Before training to become a counsellor Oli worked as a newspaper and magazine journalist, and also as an English teacher while living in Vietnam.
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